Provider Demographics
NPI:1912138405
Name:MALIK, RAABEAA ATA (MD)
Entity type:Individual
Prefix:DR
First Name:RAABEAA
Middle Name:ATA
Last Name:MALIK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4545 CENTER BLVD APT 3521
Mailing Address - Street 2:
Mailing Address - City:LONG ISLAND CITY
Mailing Address - State:NY
Mailing Address - Zip Code:11109-5976
Mailing Address - Country:US
Mailing Address - Phone:651-238-9809
Mailing Address - Fax:
Practice Address - Street 1:1111 AMSTERDAM AVE
Practice Address - Street 2:CLARK 7
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10025-1716
Practice Address - Country:US
Practice Address - Phone:651-238-9809
Practice Address - Fax:212-523-7410
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-31
Last Update Date:2023-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN104455207R00000X, 208M00000X
NY265374207R00000X
NY265374-1208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine